Microorganisms of the genus Chlamydia are obligate intracellular parasites of eukaryotic cells. They grow and multiply in the host cell forming an inclusion in the cytoplasm of the cell and cause a host of clinical syndromes.
The genus Chlamydia is made up of three distinct species: Chlamydia psittaci, Chlamydia trachomatis, and Chlamydia pneumoniae. Of these species, Chlamydia trachomatis and Chlamydia pneumoniae are commonly pathogenic for humans causing diseases such as conjunctivitis, trachoma genital infections, and pneumonia.
To detect Chlamydia trachomatis, clinical specimens are inoculated onto eukaryotic cell culture monolayers, incubated for 48 hours or more, then stained with either iodine or Giemsa. Various immunofluorescence assays are also used to detect Chlamydia trachomatis antigens and to detect antibodies produced in response to chlamydial infection. The use of immunofluorescence for detection of chlamydial antigens involves exposing clinical specimens suspected of containing chlamydia to fluorescein isothiocyanate (FITC) labeled monoclonal antibodies directed to chlamydial antigens.
Immunofluorescence techniques for the detection of anti-chlamydial antibodies include microimmunofluorescence (MIF) and indirect immunofluorescence. MIF assays are performed by fixing purified organisms to microscope slides. Both MIF and indirect immunofluorescence utilize Chlamydia as a reagent for the detection of antibodies to the organism in patient specimens. MIF utilizes purified Chlamydia fixed to a glass slide while indirect immunofluorescence utilizes Chlamydia growing in tissue culture cells as intracytoplasmic inclusions on the periphery of the nucleus of infected cells. Enzyme immunoassays are also used for the detection of Chlamydia species. All of these methods are laborious and time consuming.
Nucleic acid hybridization techniques such as dot blots, slot blots, Southern blots, solution hybridization, and in situ hybridization have been proposed as potentially useful methods for detecting a variety of pathogens including Chlamydia trachomatis. Polymerase chain reaction (PCR) procedures such as described in U.S. Pat. No. 4,683,195 to Mullis et al. have also been proposed for use in detection of a variety of pathogens.
PCT application No. WO 88/03957 published Jun. 25, 1988 by Hogan et al., addresses the detection of non-viral organisms using nucleic acid hybridization techniques. The method comprises constructing an oligonucleotide that is complementary to a region of fibosomal RNA selected to be unique to a particular non-viral organism sought to be distinguished. The Hogan application addresses oligonucleotide sequences which may be useful in the detection of Chlamydia trachomatis including sequences directed to 16S and 23S fibosomal RNA corresponding to sequences at bases 60-105, 175-210, 600-635, and 830-870, respectively of E. coli rRNA, and to sequences at bases 275-320, 330-365, 1160-1190, 1450-1490, 1510-1545, and 1710-1750, respectively of E. coli 23S RNA. The application also addresses probes directed to numerous other non-viral organisms.
Of additional interest to the background of the invention, is an alternate method for nucleic acid amplification known as the ligase chain reaction (LCR). In LCR, probe pairs are used which include two primary (first and second probes) and two secondary (third and fourth) probes all of which are employed in molar excess to target. The first probe hybridizes to a first segment of the target strand and the second probe hybridizes to a second segment of the target strand, the first and second segments being contiguous so that the primary probes abut one another in 5' phosphate-3' hydroxyl relationship and so that a ligase can covalently fuse or ligate the two probes into a fused product. In addition, a third (secondary) probe can hybridize to a portion of the first probe and a fourth (secondary) probe can hybridize to a portion of the second probe in a similar abutting fashion. Of course, if the target is initially double stranded, the secondary probes will also hybridize to the target complement in the first instance. Once the ligated strand of primary probes is separated from the target strand, it will hybridize with the third and fourth probes which can be ligated to form a complementary, secondary ligated product. It is important to realize that the ligated products are functionally equivalent to either the target or its complement. By repeated cycles of hybridization and ligation, amplification of the target sequence is achieved. This technique is described more completely in EP-A-320 308 to K. Backman published Jun. 16, 1989 and EP-A-439 182 to K. Backman et al., published Jul. 31, 1991 both of which are incorporated herein by reference.
Despite the currently available techniques, there remains a need for a sensitive, rapid, specific and reproducible technique for the detection of Chlamydia trachomatis.